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Bill
Adds Drug Benefit; Vote Is Victory for President Bush
By
Robert Pear and Carl Hulse, the New York Times (Terence
Neilan contributed reporting for this article from WASHINGTON, Nov. 25 - The Senate passed a sweeping Medicare bill today that would add new prescription drug benefits for millions of seniors as part of the biggest revision in the program since it was created in 1965 as a cornerstone of the Great Society. The bill now goes for signing to President Bush, who has made passage of the legislation a domestic priority. The Senate approval, by a 54-44 vote, is a political victory for Mr. Bush, who hopes to use it in his re-election campaign to support his contention that Republicans can be trusted more than Democrats to protect the interests of older Americans. The debate over the bill in the Senate was contentious right up to the end. On Monday, Republicans beat back two major challenges to the bill. This morning, Republicans and Democrats continued to spar over whether the bill was the right way to go, and Tom Daschle, Democrat of South Dakota, vowed that he would continue to fight what he said was deeply flawed legislation. ``This is not the final vote,'' Mr. Daschle, the minority leader, said. ``This is the beginning of the end; it is not the end. We will see many many more votes. ``I predict that we will be back within the next 12 months. Seniors will demand that we respond to the many deficiencies of this bill, and they will not rest until we address them.'' He said seniors were about to be subjected ``to a scheme for benefits they can't even understand much less afford,'' adding, ``Taxpayers already know that they're going to be giving huge handouts to insurance companies, drug companies and special interests, even though our country is faced with deficits unlike we have ever known.'' Mr. Daschle concluded by saying ``I'm not proud of this legislation. I can't put my signature on this bill, and I don't think anyone else should either.'' In reply, Senator Bill Frist, Republican of Tennessee, said Medicare has stood still, but ``today that will change'' with the overwhelming support of 238 organizations that he displayed on a blue and white chart. The groups included the AARP, the Seniors Coalition, the American Medical Association and the American Hospital Association. The Medicare bill had been a long time coming, said Dr. Frist, the majority leader, ``but it's finally here,'' with the bipartisan majority of the Senate. ``For the first time under Medicare, 40 million seniors and individuals with disabilities will finally have the prescription drug coverage they need and the Medicare choices they deserve.'' The drug benefit, covering about 75 percent of prescription costs up to $2,250 a year, would start in 2006. Before then, Medicare beneficiaries could save money by using drug discount cards approved by the government. The bill would also give insurance companies and private health plans a huge new role in Medicare. On Monday the Republican victory on Medicare was partly offset when Senate leaders abandoned efforts to pass an energy bill that was second only to Medicare as a priority for the Bush administration and the Republican-controlled Congress. As Congress rushed to wrap up its 2003 session, an important spending bill was also teetering. With Democratic help, the Republican majority in the Senate broke a filibuster against the Medicare bill led by liberal Democrats. Then, on a close vote, the Senate defeated a budget challenge to the measure. The House approved the Medicare bill on Saturday, by a vote of 220 to 215, after an all-night session that ended with an extraordinary three-hour roll call. Eight of the nine Democrats running for
president criticized the measure, calling it a threat to Medicare and a
boon for special interests. ``This is a continuation of this
administration and this Republican Party selling out government to special
interests,'' Representative Richard A. Gephardt of Senator Frist hailed the votes on Monday. ``Today is a historic day and a momentous day,'' Dr. Frist said. ``Seniors have waited 38 years for this prescription drug benefit to be added to the Medicare program. Today they are just moments away from the drug coverage they desperately need and deserve.'' William D. Novelli, chief executive of AARP, appeared at Dr. Frist's side, urging swift action by the Senate. AARP's endorsement was seen as a turning point for the bill, which Mr. Novelli said would be especially helpful to people with low incomes or high drug costs. Supporters of the Medicare bill gained momentum as they prevailed in two showdowns on Monday. By a vote of 70 to 29, the Senate ended a filibuster led by Senator Edward M. Kennedy, Democrat of Massachusetts, and others who contend argue that the bill would privatize Medicare, the federal health insurance program for 40 million people. Twenty-two of the Senate's 48 Democrats voted with most Republicans to end the debate. The Senate then voted, 61 to 39, to ignore budget rules that could have killed the legislation. Besides adding drug benefits to Medicare, the bill would inject competition and market forces into the program, establish a mechanism to monitor its finances and offer more than $70 billion in tax-free subsidies to employers, to encourage them to continue providing drug benefits to retirees in the coming decade. The Congressional Budget Office says premiums for the new drug benefit would average $35 a month. After the beneficiary paid a $250 deductible, Medicare would cover three-fourths of drug costs from $251 to $2,250. Coverage would then stop until the beneficiary had spent $3,600 out of pocket. After that, the beneficiary would pay 5 percent of the cost of each prescription. The bill would also increase payments to doctors and hospitals, provide $25 billion in assistance to rural health care providers over the next 10 years and establish tax breaks for people who set aside money in accounts for medical expenses. Under the bill, people with incomes over $80,000 a year would, for the first time, have to pay higher premiums for the part of Medicare that covers doctors' services. The most contentious provision in the bill would require the traditional Medicare program to compete directly with private health plans in a maximum of six metropolitan areas, starting in 2010. If traditional Medicare cost more, its beneficiaries would have to pay higher premiums. Conservative House Republicans say such competition would save money for Medicare in the long run. But many Democrats say it would increase premiums for beneficiaries who remain in traditional Medicare. The House approved Medicare drug bills in 2000 and 2002, only to see them wither in the Senate. Since he became majority leader, Dr. Frist, a heart transplant surgeon, has made clear that no issue is more important to him. The original version of the House bill was passed by one vote this year, but the original Senate bill had strong support from members of both parties. Senator John McCain of Arizona, one of three Republicans who voted against ending debate on the legislation on Monday, said it was ``outrageous'' that the bill prohibited federal officials from using the purchasing power of the Medicare program to negotiate prices with drug makers. Senator Charles E. Grassley, Republican of Iowa, said a similar prohibition appeared in prescription drug bills offered by Democrats in previous years. Copyright
© 2002 Global Action on Aging |
